MEDICARE: MICHAEL JOHN MARCINCZYK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	0101230296	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	770003095	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841261245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOHN MARCINCZYK MD

Provider Business Mailing Address
First Line	:	PO BOX 277771
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-7771
Country	:	US
Telephone Number	:	610-644-8900
Fax Number	:	484-924-0053

Provider Business Practice Location Address
First Line	:	2235 STAPLES MILL RD STE 104
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-2942
Country	:	US
Telephone Number	:	804-355-9729
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	02/22/2023

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